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Patient Discharge Instructions: Thoracic or Lumbar Spine Fusion

Your surgeon has written the following discharge instructions for you. Please take the time to review these instructions prior to leaving the hospital. We will be happy to answer any questions you may have.

First Follow-Up Appointment

You should have a follow-up appointment already made at the time of your hospital discharge. If not, please contact our office at (920) 882-8200 or toll free (888) 231-5236 as soon as possible so an appointment can be made.

Incision Care

Your incision may be closed with sutures or Steri-Strips. The dressings should be removed on your first or second post-operative day. If drainage persists, you may apply a light dressing and change it daily. Your incision can otherwise remain uncovered since dressings can trap moisture, which may lead to infection. Unless instructed to do so, do not apply any antibiotic ointments or antiseptics on the incision. Do not pull at Steri-Strips or sutures. They will be removed at your follow up visit in 7-14 days. If you have Steri-Strips they may fall off on their own in 7-10 days or will be removed at your postop appointment. You may shower but avoid swimming or other activities that would involve submerging the incision under water until it is well healed (2-3 weeks).

If you had bone graft taken through a separate incision or bone marrow aspirated from your hip, you may have Steri-Strips and or a Band-Aid on the site. The above information applies to these sites as well.

Cryo-Cuff Cooling Device or Standard Ice Packs

You may have been given a special device to help you apply cold to your back following surgery. Whether you have a special device or not, we recommend that you apply ice or a cold pack at least 20 minutes every few hours for the first 48 hours while awake. It is used to decrease inflammation and relieve pain. You will find cold application helpful if you do it regularly in the first 1-3 weeks.

Pain Medication

You will be given a prescription for pain medication such as Percocet (oxycodone/acetaminophen) or Vicodin (hydrocodone/acetaminophen). Please use this as directed by your provider for moderate to severe pain. Narcotic pain medication can cause constipation, dizziness, nausea, headache and decreased energy. Use the narcotic pain pills only when needed, as the goal is to discontinue them as soon as possible.

For mild to moderate pain you may take Tylenol (acetaminophen) 325-1000 mg every 4-6 hours, as needed. Please note that Tylenol is often a component of some common narcotic and non-narcotic pain relievers. Tylenol from all sources should not exceed 3000mg in 24 hours when used on a daily basis. Older people or those with kidney or liver impairment may be advised to take lower doses of Tylenol. To prevent constipation caused by narcotics, drink 6-8 glasses of water per day and eat plenty of fruits and vegetables. If needed, an over the counter stool softener or laxative can be purchased. If you continue to have trouble with constipation, contact your primary health care provider for further instructions.

Any need for prescription refills should be addressed with our office during regular business hours by calling (920) 882-8200 or toll free at (888) 231-5236. Some pain medications such as oxycodone require a written prescription. In that case, a refill cannot be phoned to the pharmacy so the prescription will need to be picked up at the office or mailed. Please allow enough time for that process.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDS such as Aspirin, Advil (ibuprofen) and Aleve (naproxen) interfere with bone fusion and should NOT be taken for 3 months following fusion surgery. Low dose aspirin prescribed for your heart is appropriate to continue after spinal fusion. If you have any questions, please ask your surgeon.

Brace

You may be fitted with a back brace or corset. A brace helps support the spine and reduce pain after an injury or surgery. The length of time in the brace will depend on the extent of injury and your doctor will let you know when it is OK to discontinue the brace. You may be permitted to remove the brace to sleep or bathe. You will be given specific instructions before you leave the hospital. If the brace was custom fitted and is causing you discomfort, please call the representative from the orthotic company that made the brace for you. They may be able to make some adjustments. You should be provided with that contact information before you leave the hospital.

Activity and Exercise

Let pain be your guide. This is not the time to catch up on major household chores or do heavy labor. Avoid repetitive bending or lifting more than 10-20 pounds for the first 12 weeks. Sitting for prolonged periods of time may cause discomfort, so it is best to change position regularly. Walking for exercise each day is encouraged. Stair climbing is permitted. You may sleep in any position you find comfortable. Water exercise may be appropriate but only after the incision is completely healed (2-3 weeks). Resume sexual activity when you are comfortable doing so.

History/Diagnosis of MRSA

Not Applicable

Driving

You should not drive while taking narcotic pain medication because it may impair your ability to drive safely. You may otherwise resume driving when you feel safe and comfortable doing so.

Smoking

We have counseled you on the importance of avoiding all forms of nicotine as it may interfere with your fusion and the success of your surgery. Each year more than 430,000 deaths in the United States are attributed to tobacco related illness. If you smoke or chew tobacco, we strongly encourage you to stop. If you would like more information on this topic, please ask us.

Please call us if:

  1. You develop a fever of 101° F or more, or redness/swelling/foul drainage at your surgical site.
  2. You develop increased neurological symptoms (confusion, weakness, numbness, tingling, etc.).
  3. You develop any adverse response to your medications.
  4. You have other questions.

** Each year more than 430,000 deaths in the United States are attributed to smoking related illness. If you smoke, we strongly encourage you to stop smoking. If you would like information about stopping smoking please ask us.

** If you have Congestive Heart Failure, please call your doctor if you experience a weight gain of 2lbs in one day, or 3lbs in 2 days or 4lbs in one week.